Disulfiram

Please note: these are basic guidelines, refer to your doctor for a professional medical opinion.

Popular brand names:

Antabuse

Drug type:

Alcohol abuse deterrent

Prescription needed?

Yes

What does it do?

Disulfiram is used to help alcohol abusers abstain from alcohol. It is a very effective deterrent to alcohol use but does not cure alcoholism.

How does it work?

Disulfiram prevents the breakdown of acetaldehyde, a by-product of alcohol metabolism.

Consuming even small amounts of alcohol whilst taking disulfiram results in an extremely unpleasant reaction due to the high levels of acetaldehyde in the blood, including:

• Flushing, throbbing headache, nausea, breathlessness, thirst, palpitations, dizziness, and fainting (which may last from 30 minutes to several hours)

How should it be used?

• Do not drink any alcohol for at least 24 hours before beginning disulfiram treatment, and for at least a week after stopping
• Avoid all foods/drinks/medicines/toiletries (including mouth wash) that contain alcohol
• Always check with your doctor or pharmacist before taking any other medication as disulfiram interacts with many drugs

What is the typical dosage?

Your doctor will recommend a dosage tailored to your need, but typically:

Start with 800mg once daily, and gradually reduce to 100–200mg daily over 5 days

How quickly will it start to work?

Negative reaction starts within a few minutes of taking alcohol.

How long will the effects last?

Reaction to alcohol can occur for up to 6 days after the last dose.

When should I stop using it?

Do not stop taking the drug without discussing with your doctor.
      

Is it safe for prolonged use?

Not usually prescribed for longer than 6 months without review.        

What are the possible side effects?

Side effects usually diminish with ongoing use, but the dose of disulfiram can be adjusted if they persist.

The following have been reported:

• Drowsiness, fatigue, nausea, vomiting, bad breath, reduced libido
• Report to your doctor before taking your next dose if you experience: any severe symtoms

What other considerations are important?

Dosage may be adjusted by your doctor under certain conditions.

• Certain health problems: liver/kidney/heart problems, coronary artery disease, high blood pressure, previous stroke, epileptic seizures, diabetes, breathing problems, depression
• Other medicines: phenytoin, anticoagulant drugs (e.g. warfarin), metronidazole, theophylline, diazepam, tricyclic antidepressants
• Pregnancy and breast-feeding: Safety not established
• Children: Not recommended
• Over 60: Reduced dose may be necessary
• Driving and hazardous work: Caution, the drug can cause drowsiness and dizziness
• Alcohol: Avoid, this drug may interact dangerously with alcohol